39D2166792 CLIA NUMBER - NEW VITAE WEST

Laboratory Demographics

  • CLIA Code: 39D2166792
  • Facility Name: NEW VITAE WEST
  • Facility Address: 5644-46 WALNUT STREET
    PHILADELPHIA, PA
    ZIP 19139
  • Facility Phone: 267 800-7170
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. HAROLD K. HECKMAN
  • NPI Number: 1902252984
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 39D2166792
LAB Type Assisted Living Facility
Facility Name NEW VITAE WEST
Street 5644-46 WALNUT STREET
City PHILADELPHIA
State PA
ZIP 19139
Phone 267 800-7170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Assisted Living Facility
Lab Director DR. HAROLD K. HECKMAN

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This page was last updated on: 9/29/2025